Evidence map›Paper›PMID 41085605›Full record

Observational studyInfection2026

Paediatric parapneumonic effusion - a twenty-year clinical narrative.

Leonie Bregy, Philipp K A Agyeman, Andrea Duppenthaler, Elisabeth Kieninger, Matthias Horn, Jonathan Juzi, Dietmar Cholewa, Carmen Casaulta, Matthias V Kopp, Christoph Aebi and 1 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Leonie BregyDivision of Paediatric Infectious Disease, Department of Paediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, CH-3010, Switzerland.
Philipp K A AgyemanDivision of Paediatric Infectious Disease, Department of Paediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, CH-3010, Switzerland.
Andrea DuppenthalerDivision of Paediatric Infectious Disease, Department of Paediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, CH-3010, Switzerland.
Elisabeth KieningerDivision of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Bern University Hospital, Inselspital, University of Bern, CH-3010, Bern, Switzerland.
Matthias HornDepartment of Paediatrics, Bern University Hospital, Inselspital, University of Bern, CH-3010, Bern, Switzerland.
Jonathan JuziDepartment of Paediatric Surgery, Bern University Hospital, Inselspital, University of Bern, CH-3010, Bern, Switzerland.
Dietmar CholewaDepartment of Paediatric Surgery, Bern University Hospital, Inselspital, University of Bern, CH-3010, Bern, Switzerland.
Carmen CasaultaDivision of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Bern University Hospital, Inselspital, University of Bern, CH-3010, Bern, Switzerland.
Matthias V KoppDepartment of Paediatrics, Bern University Hospital, Inselspital, University of Bern, CH-3010, Bern, Switzerland.
Christoph AebiDivision of Paediatric Infectious Disease, Department of Paediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, CH-3010, Switzerland.
Nina SchöbiDivision of Paediatric Infectious Disease, Department of Paediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, CH-3010, Switzerland. nina.schoebi@insel.ch.ORCID http://orcid.org/0000-0001-5240-5016

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePaediatric parapneumonic effusion (PPE) is accompanied by an increased risk of complications, e.g., sepsis or lung sequelae. Treatment strategies span from antibiotics alone to surgical interventions, but an internationally accepted guideline is lacking. With this study, we aim to better understand how management strategies influence short-term outcome parameters, like length of stay, antibiotic treatment duration, and lung damage.

methodsRetrospective observational single-centre study. Patients admitted from 1 July 2004 to 30 June 2024 with PPE to our tertiary hospital were analysed. We used the exact Jonckheere-Terpstra test to analyse trends over time.

resultsA total of 278 patients were included, 23 (8%) had to be excluded for lack of informed consent. A majority (173/255, 68%) were treated with pleural drainage. Over time, drains were increasingly more often inserted without surgery, 20% vs. 65% (p = 0.001) in 2004-2008 vs. 2020-2024. Intravenous antibiotic treatment duration declined from 15 days in 2004-2008 to 11 days in 2020-2024, p = 0.002. The most commonly identified pathogen was S. pneumoniae (39%), followed by S. pyogenes (18%). S. pyogenes compared to S. pneumoniae was more often associated with sepsis or toxic shock (45% vs. 6%, p < 0.0001), but fewer patients showed radiologic evidence for acute lung damage (68% vs. 23%, p < 0.001).

conclusionWe found considerable clinical differences in patients with PPE caused by S. pneumoniae vs. S. pyogenes. The former was associated with substantially greater lung damage.

Indexed as

Pleural EffusionAdolescentAnti-Bacterial AgentsChildChild, PreschoolDrainageFemaleHumansInfantLength of StayMaleRetrospective StudiesStreptococcus pneumoniaeStreptococcus pyogenesAnti-Bacterial AgentsGASHospitalisationParapneumonic effusionPleural drainagePleural empyemaVATS

Identifiers

PMID41085605
PMCPMC12864278

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.